Provider Demographics
NPI:1588816771
Name:POLLACK, ROBERT W (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:W
Last Name:POLLACK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10800 CORKSCREW RD STE 210
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-9453
Mailing Address - Country:US
Mailing Address - Phone:844-290-7300
Mailing Address - Fax:888-769-5641
Practice Address - Street 1:10800 CORKSCREW RD STE 210
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-9453
Practice Address - Country:US
Practice Address - Phone:844-290-7300
Practice Address - Fax:844-787-9900
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 262702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL058912800Medicaid
FL68076OtherBCBS
FL68076RMedicare PIN